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Cost, insurance authorization affect decision making in treatment of uveitis
Among uveitis and retina specialists, cost, insurance prior authorization, pregnancy considerations and subspecialty practice were factors affecting therapeutic decisions for managing uveitis in one study.
Researchers sent an email survey to physician members of the American Uveitis Society, the Macula Society and the American Society of Retina Specialists. Response rate was 11.3%, with 106 of 934 physicians participating in the survey: 44 uveitis specialists and 62 retina specialists.
When presented with a hypothetical case of ocular Behçet’s disease, 44% of responding uveitis specialists chose an immunomodulator as first choice therapy, but when cost and prior authorization were no longer a concern, the uveitis specialists were much more likely to choose a biologic as treatment. There was not a significant change among retina specialists’ treatment decisions in that regard.
In a hypothetical case of a patient with intermediate uveitis, 25% of uveitis specialists chose a local implant as their first-choice treatment option after equalization of cost compared to 79% of retina specialists.
“Our results show that uveitis specialists use local implants less than retina specialists, which means that uveitis specialists actually treat uveitis more frequently with medications used off label than do retina specialists,” the study authors said.
When pregnancy was considered, both uveitis and retina specialists tended toward increased use of local steroid therapies.
Disclosure: See the study for full list of all authors’ relevant financial disclosures.